1Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA

broutinh{at}mail.nih.gov

May improve control of measles but is no substitute for doses given at 9-15 months

Before vaccination, measles was ubiquitous and caused many deaths in children under 5 years. Routine vaccination in high income countries since the 1960s has successfully controlled measles. In low income countries, measles vaccination was included in the World Health Organization’s expanded immunisation programme since 1974. Interruption of measles transmission has been documented in most countries of the Americas,1 and the recent increase in vaccination coverage in Africa has been followed by an estimated 75% decline in annual mortality over the past decade. However, the disease remains an important and unacceptable cause of death in Africa and South Asia.

In the linked randomised controlled trial, Martins and colleagues assess the protective efficacy of vaccination at 4.5 months in infants during an outbreak in Guinea-Bissau.2 In most nations, vaccination strategies are based on the provision of a first dose at age 9-15 months and …